Edlow Jonathan A
Beth Israel Deaconess Medical Center, Boston, Massachusetts.
J Emerg Med. 2024 Dec;67(6):e622-e633. doi: 10.1016/j.jemermed.2024.06.009. Epub 2024 Jul 3.
Three validated diagnostic algorithms for diagnosing patients with acute onset dizziness or vertigo (HINTS, HINTS-plus and STANDING) exist. All are extremely accurate in distinguishing peripheral from central causes of dizziness when done by experienced clinicians. However, uptake of these diagnostic tools in routine emergency medicine practice has been sub-optimal, in part, due to clinicians' unease with the head impulse test, the most useful component contained of these algorithms. Use of these validated algorithms is the best way to accurately diagnose patients with acute dizziness. For clinicians who are unfamiliar with or uncomfortable performing or interpreting HINTS and STANDING, this article will suggest alternative approaches to help with accurate diagnosis of patients with acute dizziness or vertigo.
目前存在三种经验证的用于诊断急性发作性头晕或眩晕患者的诊断算法（HINTS、HINTS-plus和STANDING）。当由经验丰富的临床医生操作时，所有这些算法在区分头晕的外周性病因和中枢性病因方面都极其准确。然而，这些诊断工具在常规急诊医学实践中的应用并不理想，部分原因是临床医生对摇头试验（这些算法中最有用的组成部分）感到不安。使用这些经过验证的算法是准确诊断急性头晕患者的最佳方法。对于不熟悉或不擅长执行或解释HINTS和STANDING的临床医生，本文将建议一些替代方法，以帮助准确诊断急性头晕或眩晕患者。
